title: Longitudinal trajectories of parental involvement in Type 1 diabetes and adolescents' adherence.
abstract: OBJECTIVE
  The purpose of this study was to examine longitudinal trajectories of parental involvement and adolescent adherence to the Type 1 diabetes regimen, to determine whether changes in multiple facets of parental involvement over time predicted subsequent changes in adolescents' adherence, and to examine whether adolescent self-efficacy mediated the effect of parental involvement on adherence.
  
  
  METHODS
  Two hundred fifty-two adolescents (M age = 12.49 years, SD = 1.53; 53.6% females) diagnosed with Type 1 diabetes mellitus, their mothers, and 188 fathers were enrolled in a 2.5-year longitudinal study. Across 5 time points, up to 252 adolescents and their parents completed measures of adherence, parental involvement (diabetes monitoring, behavioral involvement in diabetes management, and acceptance), and adolescent diabetes self-efficacy.
  
  
  RESULTS
  Using multilevel modeling, analyses indicated significant average declines over time in adherence and most indicators of parental involvement. Lagged multilevel models indicated that declines in mothers' and fathers' acceptance and diabetes monitoring predicted subsequent declines in adolescents' adherence. Additional analyses revealed that longitudinal associations between both maternal acceptance and diabetes monitoring and subsequent adolescent adherence were mediated by adolescents' self-efficacy.
  
  
  CONCLUSIONS
  Results of this study, which were largely consistent across reporters, highlight the importance of maintaining parental involvement in diabetes across adolescence and suggest that parental involvement is beneficial for adolescents' adherence, in part, because it contributes to higher self-efficacy for diabetes management among adolescents.
authors.affiliation: Department of Psychology, University of Utah.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: King
authors.affiliation: Department of Psychology, University of Utah.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berg
authors.affiliation: Department of Psychology, University of Utah.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Butner
authors.affiliation: Department of Psychology, University of Utah.
authors.forename: Jorie M
authors.initials: JM
authors.lastname: Butler
authors.affiliation: Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wiebe
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055361:Multilevel Analysis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy